HK1032207B - First aid chirurgical instrument - Google Patents

Description

The invention relates to a coniotomy device for emergency medicine, in particular a suction coniotomy device with a trokar, a tracheal tube and an external neck cuff.

The design of the device is well known, e.g. the DE 88 85 715 C7 shows a device in which a cuff to be placed on the neck with a flange inclined below 45° to the cuff surface is fitted with a fastener into which an axially guided catheter system with cannula and mandrin can be inserted and which, after being introduced into the respiratory tract, must be attached to the fastener by means of a clamping device.

US PS 8 906 956 is another example of such an instrument, having an L-shaped configuration and an opening for a trokar.

US PS 4 291 690 also reveals a similar instrument which has a self-limiting penetration depth up to the posterior third of the trachea and, starting from an oval flange on either side, has tubular supports for the passage of an air tube to be inserted into the trachea.

Finally, similar instruments have also become known from the two US PS 34 76 112 and 29 23 299 and DE PS 19 514 433.

It is clear that these well-known coniotomy devices have considerable disadvantages: they are too complex to be used in emergencies, they have too many parts to be fitted before the procedure, and they are too cumbersome to be used even by an experienced doctor in such situations, which can result in a loss of time which may be life-saving.

The purpose of the invention, as described in the claims, is to create a coniotomy apparatus which is simple in construction, quick and easy to operate, allows visual contact with the trachea and, if necessary, i.e. in the case of serious injuries, e.g. in the jaw area, safely prevents the escape of air into the trachea through the upper part of the larynx and, if necessary, the air from the upper part of the throat.

The advantages of the invention are in particular the simple construction of the coniotomy apparatus consisting of only two strands, with internal and external self-attachment by the end-circular winding of the resting tube or by the lateral fixing wings of the base part, and, because of its straight shape, its quick and easy handling, which is particularly important in exceptional emergencies. Furthermore, no contact of the instrument with the inner wall of the trachea, which largely excludes reflective spasms. Another advantage is that the measuring form, i.e. a cutting tube with a vertical flow, prevents the elastic plastic part of the ligament from being separated.

Finally, the insertion of the blocking cannula into the base part is quite easy.

The invention is explained in more detail below by an example of an embodiment shown in the illustrations.

It shows: Figure 1 shows a horizontal section through the coniotomy apparatus with Trokar and Figure 2 shows a vertical section of Figure 1 with blocking cannulas, each with a view.

As can be seen from Figure 1, the coniotomy apparatus consists essentially of only two parts, namely the base part 1 and the trokar 8. The base part 1 is fitted with two fixing wings 2 and 3 to fix it externally on the patient's neck. 17 each denotes an eye. The base part 1 also has an approach 4 for the suction shown only in the illustration. It has an ampoule bag, an air balloon 7 and a resting channel to be inserted into the patient's trachea 23. 5. The conial canal 5 is short and has a finite circular fixture 6 which prevents the colonic device from slipping, the insertion of which into the 23 trachea prevents the colonic device from being attacked by an external fixture. 8 The trokar can be limited to the outside and the inside by a scalpel ring 11 and, if necessary, a scalpel ring 8 which can be attached to the trachea.

For better understanding, the diagrams show the thyroid cartilage with 19, the ring cartilage with 20, the skin with 21 and the mucous membrane of the trachea with 23.

It has been shown to be advantageous to limit the optimum length L of the suspension tube 5 between the base part 1 and its end to about 17 mm, including the final wool, which should be about 1 mm thick. For special applications, for example, the suspension tube 5 may also be telescopically trained to adjust its length if necessary. The inner diameter of the suspension tube 5 is sufficiently measured at 4-6 mm, with a diameter of 6 mm for large adults. To prevent the rotation of the trocar 8 a fixing nut and spring 14 is provided in at least one part of the suspension tube 5 and the trocar 8 and its shaft 9 respectively. This ensures that the base 1 is correctly installed at the intersection of the scalar cutting edge of the trocar (8)

A further development of the invention involves the insertion into the passage of the resting ducts 5 of a blocking duct 18 having two separate air ducts, one of which is fitted with an air duct 12 on the outside with a closing membrane 13 and which ends inside in a closing sac 15 at its end.

The tracheal tube 5 is straight and very short, and gives the attending physician sufficient visual contact with the trachea T. After removal of the tracheal tube 8, a thin fiberglass cable, not shown in the figures, also provides lighting for the inner wall of the trachea. For example, the tracheal tube 5 can also be used to insert a suction device or glomerule. Photographic images can also be taken by means of an endoscope inserted through the tracheal tube 5 etc. Finally, the fixer 6 can be used as a lighting device for the trachea T. The use of such suction, lighting and/or vision devices, etc., can only be used in this case, although the necessary measures are already available for the preparation of the treatment of the tracheal tube.

Err1:Expecting ',' delimiter: line 1 column 1366 (char 1365)

The invention is not, of course, limited to the use of the closed airway in the throat and the ENT region, but can also be used successfully in various other surgical applications.

List of items

1 base part2 anchorage wings 13 anchorage wings r4 anchorage for bags5 anchorage tubes6 anchorage bushing for bags7 anchorage tubes8 anchorage bushing9 trolley shank10 anchorage section11 anchorage to trolley or anchorage tubes12 air channel for bags13 closing membrane14 anchorage outer and anchorage spring15 anchorage bags16 air supply 17 holding tube18 anchorage tubes19 thyroid gland20 ring knob21 skin22 skin 23 trachea

Claims (9)

1. Coniotomy device for emergency respiration with a trocar (8) inserted through an indwelling cannula (5) that can be inserted into the trachea (23) and with a cuff to be positioned externally on the neck for attaching the base part (1) of the device to be positioned at the front of the neck of the patient, with the base part (1) having lateral fixation wings (2, 3) at its front end near the neck and a fixation device at the tracheal end, the indwelling cannula (5) being designed over its entire length as a passage channel for the shaft (9) of the trocar (8), with this shaft (9) having a scalpel-like cutting edge (10) and the base part (1) with its indwelling cannula (5) being able to be positioned vertically on the neck of the patient and the indwelling cannula (5) also being able to be inserted vertically in the patient's trachea (23), and having a fitting (4) for air bellows (7) at the rear end remote from the patient's neck, characterised in that the straight indwelling cannula (5) projecting centrally from the base part (1) forwards in the direction of the neck of the patient has a circular fixation bead (6) permanently moulded onto its end and the scalpel-like cutting edge (10) of the trocar (8) runs from cranial to caudal and thus parallel to the elastic fibres of the ligamentum conicum.
2. Coniotomy device for emergency medicine in accordance with Claim 1, characterised in that the length (L) of the section of the indwelling cannula (5) inserted into the body of the patient is about 17 mm, the internal diameter of the indwelling cannula (5) is about 4 - 6 mm and its fixation bead (6) has a radial thickness of about 1 mm.
3. Coniotomy device for emergency medicine in accordance with Claim 1 or 2, characterised in that a blocking cannula (18) can be inserted through the indwelling cannula (5) into the trachea (23) and that through its air channel (12) a closure bag (15) for the trachea (23) can be inflated.
4. Coniotomy device for emergency medicine in accordance with Claim 3, characterised in that the blocking cannula (18) has an air channel (12) and an air supply line (16) separate from said air channel, the air channel (12) being closed at the end remote from the patient's neck by means of a closure membrane (13), and leading into a closure bag (15) at the patient end.
5. Coniotomy device for emergency medicine in accordance with one of Claims 1 to 4, characterised in that the cutting edge (10) of the trocar (8) is intended to be positioned vertically with respect to the cricoid cartilage (20) and does not project beyond the fixation bead (6) by more than 7 mm.
6. Coniotomy device for emergency medicine in accordance with one of Claims 1 to 5, characterised in that the shaft (9) of the trocar (8) has a limit stop (11).
7. Coniotomy device for emergency medicine in accordance with Claim 6, characterised in that the limit stop (11) on the shaft is adjustable in its axial direction.
8. Coniotomy device for emergency medicine in accordance with one of Claims 1 to 7, characterised in that the indwelling cannula (5), the trocar (8) and the blocking cannula (18) have a fixation tongue and groove (14).
9. Coniotomy device for emergency medicine in accordance with Claim 1, characterised in that suction, inspection and illumination equipment for the trachea (23) can be inserted into the indwelling cannula.